The Prevalence and Predictors of Atrioventricular Blocks in Syrian Patients Reporting to the Emergency Department During the Ongoing Conflict: A Cross‐Sectional Study
posted on 2025-09-18, 11:17authored byIbrahim Antoun, Alkassem Alkhayer, Aref Jalal Eldin, Alamer Alkhayer, Khaled Yazji, Riyaz Somani, G André Ng, Mustafa ZakkarMustafa Zakkar
<p dir="ltr">BackgroundAtrioventricular block (AVB) is a cardiac conduction disorder that can lead to significant clinical outcomes, particularly in resource‐limited and conflict‐affected regions. In Syria, healthcare infrastructure has been severely impacted by ongoing conflict, potentially affecting the prevalence and management of AVB.MethodsWe conducted a cross‐sectional study at Tishreen University Hospital in Latakia, Syria, with patients > 40 who presented to the emergency department (ED) from June 1 to August 1, 2024. Routine 12‐lead ECGs were performed, with AVB diagnoses confirmed by two independent cardiology consultants. Exclusion criteria included pre‐existing AVB, pacemaker presence, hemodynamic instability, and ECG diagnostic discrepancies. Patient demographics and comorbidities were assessed, and logistic regression analyses identified predictors of AVB.ResultsThe final analysis included 692 patients, of which AVB was detected in 7% of the cohort. Patients with AVB were significantly older (median age 76 vs. 54 years, p < 0.001) and had higher rates of ischemic heart disease (IHD) (62% vs. 14%, p < 0.001) and diabetes (56% vs. 21%, p = 0.01). Logistic regression showed older age (odds ratio [OR]: 2.8, 95% confidence interval [CI]: 1.6−5.6, p < 0.001), IHD (OR: 1.9, 95% CI: 1.4−4.5, p < 0.001), and DM (OR: 3.9, 95% CI: 2.9−8.3, p < 0.001) were independently associated with AVB.ConclusionAVB prevalence in the Syrian ED setting is high, with age, IHD, and diabetes as significant predictors. Routine ECG screening in EDs may facilitate early AVB detection in at‐risk populations, especially in conflict‐affected regions with limited healthcare resources. This approach could improve outcomes by enabling timely intervention in high‐risk patients.</p>
Funding
British Heart Foundation Research Excellence Award (RE/24/130031)
Neurocardiac interaction in malignant ventricular arrhythmias and sudden cardiac death
LifeMap Quality-assurance User-focussed Evaluation of Safety and Tolerability (LifeMap-QUEST) : developing LifeMap-Vest and LifeMap-Compute for exercise assessment with optimised digital ECG recording for sudden death risk stratification